Metacognitive executive function training for young children with ADHD: a proof-of-concept study.
Metacognitive executive function training for young children with ADHD: a proof-of-concept study.
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患有多动症的幼儿的元认知执行功能训练：一项概念验证研究。
DOI：
10.1007/s12402-014-0162-x
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
Nakonezny,PaulA
中科院分区：
文献类型：
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作者：
Tamm,Leanne;Nakonezny,PaulA
注意力缺陷多动障碍（ADHD）儿童的执行功能（EF）受损。这可能是特别重要的干预措施，以针对EF在幼儿期的EF缺陷，可能会导致以后的功能障碍的发展进程。这项概念验证研究检查了EF和ADHD干预计划的初步疗效。我们还研究了儿童在三个神经认知任务上的表现，评估认知灵活性，听觉/视觉注意力和持续/选择性注意力。ADHD儿童（3-7岁）及其父母随机接受针对元认知功能EF缺陷的干预（n= 13）或等待控制条件（n= 12）。协方差线性模型分析比较了父母EF评分，ADHD症状和改善的盲法临床医生评分以及儿童神经认知指标的表现。接受干预的儿童在注意力转移和情绪调节的父母评级以及临床医生对注意力不集中的评级方面都有显着改善。中等效应量显示，对父母的抑制、记忆和计划评分以及多动/冲动和总体改善的临床医生评分有额外的干预效应。观察到儿童神经认知指标改善的效应量较小。虽然需要更大的样本和积极的对照组进行复制，但以元认知为重点的EF训练对ADHD幼儿来说是一种潜在的有希望的干预措施。
Executive functions (EF) are impaired in children with attention-deficit/hyperactivity disorder (ADHD). It may be especially critical for interventions to target EF in early childhood given the developmental progression of EF deficits that may contribute to later functional impairments. This proof-of-concept study examined the initial efficacy of an intervention program on EF and ADHD. We also examined child performance on three neurocognitive tasks assessing cognitive flexibility, auditory/visual attention, and sustained/selective attention. Children with ADHD (ages 3–7) and their parents were randomized to receive an intervention targeting metacognitive EF deficits (n= 13) or to a waitlist control condition (n= 12). Linear model analysis of covariance compared groups on parent EF ratings, blinded clinician ratings of ADHD symptoms and improvement, and child performance on neurocognitive measures. Children who received the intervention significantly improved on parent ratings of attention shifting and emotion regulation in addition to clinician ratings of inattention. Moderate effect sizes showed additional intervention effects on parent ratings of inhibition, memory, and planning, and clinician ratings of hyperactivity/impulsivity and overall improvement. Small effect sizes were observed for improvement on child neurocognitive measures. Although replication with a larger sample and an active control group is needed, EF training with a metacognitive focus is a potentially promising intervention for young children with ADHD.